（耳中出血、双目出血）
其云鼻大衄者，是因鼻衄而口耳鼻皆出血，故云鼻大衄也。（《病源论》）
耳目口鼻窍中一齐出血，药不及煎，死在旦夕俄顷。用冷水当面 几口，急分开头发，用粗纸数层，蘸醋
令透，搭在囟门，血即止。次以当归一两煎汤，磨沉香、降香各五钱，加童便服之，血自归经。然后以四物汤
加人参、黄 、北五味、麦门冬服之，可收万全之功。（《疡医大全》）《医镜》不用降香。
九窍四肢出血候∶凡荣卫大虚，腑脏伤损，血脉空竭，因而恚怒失节，惊忿过度，暴气逆溢，致令腠理开
张，血脉流散也，故九窍出血，喘咳而上气逆。其脉数，有热，不得
卧者，死。（《病源论》）
葛氏人有九窍四肢指歧间皆血方，以井华水 其面（按∶面字原讹血，据《本草》改），令卒然至。勿使病
者先知，即佳矣。姚氏云∶此暴惊所为。（《肘后》）
龙骨末，九窍出血者，皆用吹之。（《千金》）
暴惊风九窍出血，其脉虚者。
灵砂百粒，分三次，人参煎汤下。此证不可错认血得热则宣流，妄用凉药，误矣。（《直指》）
九窍出血，是证非中毒即跌扑受伤。中毒者，用生羊血等法（按∶此用羊血，本出姚氏治暴惊所为）。受伤
者，观其人不发热，尚能饮食者，频灌热童便。无故发热，九窍出血者，肝肾疲极，五脏内崩也，多不可治，若
见血水必死。（《医通》）
诸耳内出血，以龙骨末吹入即止。（《三因》）或者矾枯为末，入麝吹之即止。（《济急仙方》）
耳中出血，芎归汤加茅根，入少盐同煎，空心服。随血之衄出左右，以新汲井水洗足，效。耳鼻口出血不止，
烧赤马粪灰，温酒调下一钱。（《永类》）
耳中出血，为耳衄。两关弦数，饮酒多怒人，属肝火，柴胡清肝散。尺脉弱或躁，属阴虚，生料六味丸加五
味子。（《医通》）
（耳中出血、双目出血）
所谓“鼻大衄”，是因为鼻衄（鼻出血）导致口、耳、鼻都出血，所以称为鼻大衄。（出自《诸病源候论》）
耳目口鼻九窍同时出血，药物来不及煎煮，患者将在片刻之间死亡。此时可用冷水泼面几口，迅速分开头发，用数层粗纸蘸透醋，敷在囟门处，血即可停止。随后用当归一两煎汤，磨入沉香、降香各五钱，加入童便服用，血液自然回归经脉。然后再服用四物汤加人参、黄芪、北五味子、麦门冬，可收万全之效。（出自《疡医大全》）《医镜》一书中不用降香。
九窍四肢出血证候：凡是营卫之气极度虚弱，脏腑受损，血脉空虚枯竭，加之愤怒失度，惊恐愤恨过度，导致暴气逆乱上溢，致使腠理开张，血脉流散，因此出现九窍出血，气喘咳嗽且气逆上冲。如果脉象数疾，伴有发热，不能安卧的，预后不良，主死。（出自《诸病源候论》）
葛氏记载有人患九窍及四肢指歧间皆出血的方剂，用井华水（清晨第一次汲取的井水）泼其面部（按：原文“面”字原误作“血”，据《本草纲目》改正），令其突然受惊而至。不要让病人预先知道，这样效果更佳。姚氏说：这是由突然受惊所致。（出自《肘后备急方》）
龙骨研成细末，对于九窍出血者，均可吹入患处止血。（出自《千金要方》）
突发惊恐风邪导致的九窍出血，脉象虚弱的。
用灵砂一百粒，分三次服用，用人参煎汤送下。此证不可误认，认为血得热则宣流而妄用凉药，那是错误的。（出自《济生拔粹·直指方》）
九窍出血，此证若非中毒，即是跌扑受伤。中毒者，使用生羊血等方法治疗（按：此处用羊血，原本出自姚氏治疗因暴惊所致之证）。受伤者，观察病人如果不发热，尚能饮食的，频繁灌服热童便。无故发热且九窍出血的，是肝肾极度疲劳，五脏内部崩裂，大多不可治愈，如果见到血水混合必死无疑。（出自《医学入门·医通》）
所有耳内出血，将龙骨研末吹入即可停止。（出自《三因极一病证方论》）或者将明矾烧枯研末，加入麝香吹入即可停止。（出自《济急仙方》）
耳中出血，用芎归汤加白茅根，放入少许盐同煎，空腹服用。根据出血是从左侧还是右侧鼻孔流出，用新汲取的井水洗脚，有效。耳鼻口出血不止，将马粪烧成灰，用温酒调服一钱。（出自《永类钤方》）
耳中出血，称为耳衄。两关脉弦数，多见于饮酒多怒之人，属于肝火，用柴胡清肝散治疗。尺脉弱或躁动，属于阴虚，用生料六味丸加五味子治疗。（出自《医学入门·医通》）
(Ear bleeding, Eye bleeding)
The term "Nasal Major Hemorrhage" (Bi Da Nu) refers to a condition where epistaxis (nosebleed) causes bleeding from the mouth, ears, and nose simultaneously; hence it is called Nasal Major Hemorrhage. (From *Zhu Bing Yuan Hou Lun*)
When blood flows from all nine orifices (eyes, ears, mouth, nose), there is no time to decoct medicine, and death occurs within moments. At this juncture, splash cold water on the face several times, quickly part the hair, soak several layers of coarse paper thoroughly in vinegar, and apply it to the fontanelle (Xinmen); the bleeding will stop immediately. Subsequently, decoct 1 liang of Danggui (Angelicae Sinensis Radix) in water, grind Chenxiang (Aquilariae Lignum Resinatum) and Jiangxiang (Daemonorops Draco Resina) each at 5 qian, add Tongbian (Urine of a healthy young boy), and administer orally; the blood will naturally return to its vessels. Thereafter, administer Siwu Tang (Four Substance Decoction) with added Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Membranacei Radix), Bei Wuweizi (Schisandrae Chinensis Fructus), and Maidong (Ophiopogonis Tuber) to achieve complete efficacy. (From *Yang Yi Da Quan*) The text *Yi Jing* does not use Jiangxiang.
Manifestation of Bleeding from Nine Orifices and Four Limbs: Whenever Ying and Wei Qi are severely deficient, Zang-Fu organs are damaged, and blood vessels are empty and exhausted, compounded by uncontrolled anger, excessive fright and indignation, causing violent Qi to reverse and overflow, leading to the opening of Couli (pores/skin texture) and the dispersion of blood vessels. Consequently, bleeding occurs from the nine orifices, accompanied by panting, coughing, and rebellious Qi rising upward. If the pulse is rapid, accompanied by fever and inability to lie down, the prognosis is fatal. (From *Zhu Bing Yuan Hou Lun*)
Ge Shi recorded a formula for patients suffering from bleeding from the nine orifices and between the fingers/toes of the four limbs. Use Jinghua Shui (well water drawn at dawn) to splash on the patient's face (Note: The original character 'Mian' [face] was erroneously printed as 'Xue' [blood]; corrected according to *Ben Cao*). This should be done suddenly. It is best if the patient is unaware beforehand. Yao Shi states that this is caused by sudden fright. (From *Zhou Hou Bei Ji Fang*)
For bleeding from the nine orifices, blow finely powdered Longgu (Fossilized Bones) into the affected areas. (From *Qian Jin Yao Fang*)
Sudden fright-induced wind causing bleeding from the nine orifices, characterized by a deficient pulse.
Administer 100 pills of Lingsha (Cinnabar and Mercury preparation), divided into three doses, taken with Renshen decoction. This condition must not be misdiagnosed; assuming that heat causes blood to flow freely and thus wrongly using cooling herbs is an error. (From *Zhi Zhi Fang*)
Bleeding from the nine orifices indicates either poisoning or trauma from falling/hitting. For poisoning, methods such as administering raw sheep blood are used (Note: The use of sheep blood here originates from Yao Shi's treatment for conditions caused by sudden fright). For trauma, observe if the patient has no fever and can still eat; if so, frequently administer hot Tongbian (Urine of a healthy young boy). If there is unexplained fever accompanied by bleeding from the nine orifices, it indicates extreme exhaustion of the Liver and Kidney, and internal collapse of the Five Zang organs; this is mostly incurable. If bloody fluid is seen, death is certain. (From *Yi Tong*)
For any bleeding inside the ear, blowing in powdered Longgu (Fossilized Bones) stops it immediately. (From *San Yin Fang*) Alternatively, calcined Mingfan (Alumen) mixed with Moshe (Moschus) blown into the ear stops it immediately. (From *Ji Ji Xian Fang*)
For bleeding in the ear, use Xiong Gui Tang (Ligusticum and Angelica Decoction) with Mao Gen (Imperatae Rhizoma) and a small amount of salt, decocted together, taken on an empty stomach. Wash the feet with fresh well water depending on whether the nasal bleeding occurs from the left or right nostril; this is effective. For continuous bleeding from the ears, nose, and mouth, burn horse manure to ash, mix with warm wine, and take 1 qian. (From *Yong Lei Qian Fang*)
Bleeding in the ear is called Ear Epistaxis (Er Nu). A wiry and rapid pulse at both Guan positions, often seen in individuals who drink alcohol and are prone to anger, belongs to Liver Fire; treat with Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder). A weak or restless Chi position pulse belongs to Yin Deficiency; treat with Sheng Liu Wei Wan (Raw Six-Ingredient Pill) plus Wuwei Zi (Schisandrae Chinensis Fructus). (From *Yi Tong*)